Taking antibiotics when you don’t need them puts you at risk

As the Chief Medical Officer and experts around the world warn of a ‘post-antibiotic apocalypse’ and ‘the end of modern medicine’, Public Health England launches a major new campaign to help ‘Keep Antibiotics Working’.

The campaign warns people that taking antibiotics when they are not needed puts them at risk of a more severe or longer infection, and urges people to take their doctor’s advice on antibiotics.

Public Health England’s ESPAUR report reveals that as antibiotic resistance grows, the options for treatment decrease. Worryingly, 4 in 10 patients with an E.coli bloodstream infection in England cannot be treated with the most commonly used antibiotic in hospitals.

Antibiotics are essential to treat serious bacterial infections, such as meningitis, pneumonia and sepsis, but they are frequently being used to treat illnesses, such as coughs, earache and sore throats that can get better by themselves.

Taking antibiotics encourages harmful bacteria that live inside you to become resistant. That means that antibiotics may not work when you really need them. It is estimated that at least 5,000 deaths are caused every year in England because antibiotics no longer work for some infections and this figure is set to rise with experts predicting that in just over 30 years antibiotic resistance will kill more people than cancer and diabetes combined.

The ‘Keep Antibiotics Working’ campaign urges the public to always trust their doctor, nurse or pharmacist’s advice as to when they need antibiotics and if they are prescribed, take antibiotics as directed and never save them for later use or share them with others. The campaign also provides effective self-care advice to help individuals and their families feel better if they are not prescribed antibiotics.

Antibiotic resistance is not a distant threat, but is in fact one of the most dangerous global crises facing the modern world today. Taking antibiotics when you don’t need them puts you and your family at risk of developing infections which in turn cannot be easily treated with antibiotics. Without urgent action from all of us, common infections, minor injuries and routine operations will become much riskier. PHE’s ‘Keep Antibiotics Working’ campaign helps to explain the risks of antibiotic resistance to the public. It is important for people to understand that if they are feeling under the weather and see their GP or a nurse, antibiotics may not be prescribed if they are not effective for their condition, but they should expect to have a full discussion about how to manage their symptoms.

Professor Dame Sally Davies, Chief Medical Officer, comments:

Without effective antibiotics, minor infections could become deadly and many medical advances could be at risk; surgery, chemotherapy and caesareans could become simply too dangerous. But reducing inappropriate use of antibiotics can help us stay ahead of superbugs. The public has a critical role to play and can help by taking collective action. I welcome the launch of the ‘Keep Antibiotics Working’ campaign, and remember that antibiotics are not always needed so always take your doctor’s advice.

Health Minister Steve Brine said:

Following on from the global Call to Action conference held this month, we are asking people to help so we can make sure antibiotics keep working. This government is firmly committed to combatting drug resistant infections and refuses to allow modern medicine to grind to a halt – simple steps can make a huge difference.

Dr Chris Van Tulleken, TV and of infectious diseases doctor at University College London Hospitals, comments:

As an infectious diseases doctor, I see first-hand what happens if antibiotics don’t work – and it’s scary. Antibiotics are not just vital for treating serious bacterial infections, they’re needed to help with other treatments like chemotherapy. Antibiotic resistance is a problem that will affect every one of us, so we all have a role to play. As GPs we are often asked to prescribe antibiotics by patients who think that they will cure all their ills. The reality is that antibiotics are not always needed so you shouldn’t expect to be prescribed them by your doctor or nurse. Always take their advice and remember that your pharmacist can recommend medicines to help with your symptoms or pain.

Public Health England’s new campaign is part of a wider cross-government strategy, involving the agricultural, pharmaceutical and healthcare sectors, which tackles the threat of antibiotic resistance by increasing supply and reducing inappropriate demand.

To help keep this precious resource in the fight against infections working, the public are asked to play their part and urged to always take their doctor, nurse or pharmacist’s advice on antibiotics.

For further information on antibiotics, their uses and the risk of resistance, search ‘NHS Antibiotics’ online.

Background

The campaign will run from Monday 23 October across England for 8 weeks and will be supported with advertising, partnerships with local pharmacies and GP surgeries, and social media.

Additional data from Public Health England’s ESPAUR report illustrates:
* four in 10 patients with an E.coli bloodstream infection in England cannot be treated with the commonest antibiotic (co-amoxiclav) used in hospitals; in addition, almost 1 in 5 of these bacteria were resistant to at least 1 of 5 other key antibiotics
* of the 1 million antibiotic resistant bacteria causing urinary tract infections identified in NHS laboratories in 2016, trimethoprim resistance was very common (37%) but the current recommended first line treatment, nitrofurantoin, remains effective (3%)
* between 2012 and 2016, antibiotic prescribing reduced by 5%, when measured as defined daily doses per 1000 inhabitants per day
* the number of antibiotic prescriptions dispensed in General Practice decreased by 13% between 2012 and 2016 (-2% from 2015 to 2016)
* dental practices dispensed 1 in 5 fewer prescriptions in 2016 compared to 2012 and more than 99% of prescribed antibiotics were in accordance with dental treatment guidelines
* hospital prescribing has increased year on year, but has reduced use of the last resort antibiotics (piperacillin/tazobactam and carbapenems) by 4% between 2015 and 2016

Self-care advice provided by the ‘Keep Antibiotics Working’ campaign in leaflets and materials distributed in GP surgeries and pharmacies across England includes:
* ask your pharmacist to recommend medicines to help with symptoms or pain
* get plenty of rest
* drink enough fluids to avoid feeling thirsty
* use paracetamol if you or your child are uncomfortable as a result of fever – which is a sign of the body fighting infection, and normally gets better by itself in most cases
* use tissues for your nose and wash your hands frequently to avoid spreading your infection to family and friends

If you or your child has any of these symptoms, are getting worse or are sicker than you would expect (even if your or their temperature falls), trust your instincts and seek medical advice urgently from NHS 111 or your GP.
If a child under the age of 5 has any of symptoms 1 to 3, go to A&E immediately or call 999:
* if your skin is very cold or has a strange colour, or you develop an unusual rash
* if you feel confused or have slurred speech or are very drowsy
* if you have difficulty breathing; signs can include:
* breathing quickly
* turning blue around the lips and the skin below the mouth
* skin between or above the ribs getting sucked or pulled in with every breath
* if you develop a severe headache and are sick
* if you develop chest pain
* if you have difficulty swallowing or are drooling
* if you cough up blood
* if you are feeling a lot worse

The campaign is part of a wider cross-government strategy to help preserve antibiotics. The government’s UK Five Year Antimicrobial Resistance Strategy 2013 to 2018 set out aims to improve the knowledge and understanding of AMR, conserve and steward the effectiveness of existing treatments, and stimulate the development of new antibiotics, diagnostics and novel therapies. In July 2014, the Prime Minister announced a review of antimicrobial resistance chaired by the economist Jim O’Neill. The subsequent report, published in 2016, recommended a number of actions to be taken globally to manage the rise of antimicrobial resistance, including public awareness campaigns.

PHE’s ‘Keep Antibiotics Working’ campaign targets the general public and is aligned Antibiotic Guardian which urges healthcare professionals and engaged members of the public to take one of a number of pledges to help personal and organisational commitment to preserve antibiotics.

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